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Organization

PROVIDENCE IN-HOME CARE, INC.

Active
Other names
Providence Skilled Nursing Care
Organization subpart
No

Provider details

NPI number
Authorized official
BETTY W. MWENJE (ADMINISTRATOR/PRESIDENT)
(301) 490-5900
Entity
Organization

Contact information

Practice address
1401 MERCANTILE LANE, SUITE # 200 AA, LARGO, MD 20774
(301) 490-5900
(301) 830-8335
Mailing address
PO BOX 8503, ALEXANDRIA, VA 22306-8503
(301) 490-5900
(301) 830-8335

Taxonomy

Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary

Other

Enumeration date
08/01/2019
Last updated
08/01/2019
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